Steroid Eye Drops: Types, Uses, Side Effects
My Daughter Has Blocked Tear Ducts
My six month old daughter has suffered from blocked tear ducts since birth and her eyes are always infected and streaming with green or yellow mucus.
I have been told it should clear with wiping it away and massaging the tear ducts.
At a year the ducts could be 'probed' but I would like to avoid that if possible and also would like to see it clear before then! Do you have any advice?
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But how do you get rid of gallstones? Surgery — in this case, a cholecystectomy, or gallbladder removal — is the most common form of treatment for gallstones. But the fact that surgically taking out gallstones requires removing an entire organ has led to a growing interest in gallstone treatment without surgery.
Why Treatment for Gallstones Is NecessaryBesides alleviating symptoms, treatment for gallstones is necessary to avoid a progression that can result in severe conditions, such as acute cholecystitis, the condition in which the gallstone blocks the gallbladder ducts, causing the gallbladder to become inflamed and infected. Patients with acute cholecystitis are usually hospitalized and receive antibiotics, pain medication, and often surgery.
If you do not have symptoms, the most common treatment is to "wait and see," because the risks outweigh the benefits for both medical and surgical treatments. If you have gallbladder symptoms, surgical treatments are preferred unless you are at high risk, and then drug treatments may be utilized.
"If someone is symptomatic, we do recommend patients get the gallbladder taken out," says Nikhil Kumta, MD, a gastroenterologist and the director of interventional endoscopy at Mount Sinai Health System in New York City. "[Gallbladder surgery] is minimally invasive, so the risk of complications is low. But if people are unable to go through surgery, if someone is really old or really sick, there are different treatment options."
Here are six methods for gallstone removal without surgery:
1. Thinning Bile With Acid Pills Can Dissolve GallstonesIn some cases, gallstones can be treated with medicine.
Certain chemicals, such as ursodiol or chenodiol, which have been shown to dissolve some gallstones, are available in oral bile acid pills. These medicines work by thinning the bile, which allows gallstones to dissolve.
While these pills can be effective and are generally well tolerated by patients, medical treatment of gallstones is limited to people whose stones are small and made of cholesterol. But according to Mount Sinai, these drugs can take two years or longer to work, and gallstones may return after treatment ends.
"Decreasing the cholesterol content of the bile can dissolve (certain gallstones), but it's not effective enough that we don't refer patients to surgery," Dr. Kumta says.
2. Small Gallstones May Be Broken Apart With Shock WavesAnother gallstone treatment without surgery for which gallstones must meet certain criteria is extracorporeal shock-wave lithotripsy (ECSWL). Although it is most commonly used to treat kidney stones, it can also be used on gallstones.
This method can only be effective on solitary gallstones that are less than 2 centimeters in diameter, so fewer than 15 percent of patients are eligible for ECSWL. The goal of the treatment is to break up, or fragment, gallstones by sending shock waves through the soft tissue of the body.
However, this form of treatment is rarely used as research has found the results to be unsatisfactory: Only 18 percent of ECSWL patients remain free of symptoms and gallstones, and 72 percent of patients later require gallbladder removal.
3. Gallstones Can Be Dissolved With an MTBE InjectionThis nonsurgical treatment option involves injecting a solvent known as methyl tertiary-butyl ether (MTBE) into the gallbladder to dissolve the gallstones. According to research, MTBE rapidly dissolves gallstones — but there can be some serious side effects, such as severe burning pain. As a result, this type of treatment is used very sparingly.
MTBE creates fumes, and if it's not administered properly in a ventilated area, it could cause severe burning for the patient and operators and even cause electrical fires. This procedure should only be considered in very select cases, and you should inquire about your doctor's level of experience with performing MTBE before getting this form of treatment.
4. Endoscopic Drainage Follows the Gallbladder's Natural PathEndoscopic drainage mimics the healthy route of bile from the gallbladder to the small intestine. An endoscopic transpapillary treatment involves accessing the cystic duct with a camera through the mouth and down the throat. Then a stent, a small tube, is placed through the duct into the gallbladder. It is coiled to imitate the trajectory of the bile out of the small intestine, which is the same process as that of a healthy gallbladder. Kumta says that this form of treatment allows the gallbladder to resume normal bile disposal.
5. Percutaneous Cholecystostomy Is Best for Seriously Ill PatientsThis is a nonsurgical treatment option, but it's most effective when followed by gallbladder removal. Percutaneous cholecystostomy (PC) is typically saved for seriously ill patients who cannot tolerate surgery right away. The procedure involves using a needle to withdraw fluid from the gallbladder and then inserting a catheter through the skin to drain the fluid. The catheter is left in place for a number of weeks, after which gallbladder removal surgery is performed to prevent recurrence.
6. Ultrasound-Guided Procedure to Drain the GallbladderEndoscopic ultrasound–guided gallbladder drainage (EUS-GBD) is a procedure for patients who have acute cholecystitis, or gallbladder inflammation, and are unable to have surgery. It involves placing an endoscopic stent between the gallbladder and alimentary tract to drain fluid, also known as transmural drainage.
"Transmural drainage creates a new tract directly through the stomach into the gallbladder," Kumta says. "This allows the gallbladder to decompress."
Previously, practitioners would use a plastic stent, but now a mesh-like metal stent, known as a lumen apposing metal stent (LAMS), is more common as it is more effective, per research.
According to a 2023 clinical practice update from the American Gastroenterological Association, EUS-GBD has a success rate of 89 to 98 percent. However, the authors note that only those very skilled in advanced therapeutic endoscopic ultrasound should perform this procedure.
When Considering Treatment Options, Talk to Your DoctorAs a gastroenterologist, Kumta always refers people to a surgeon if they are experiencing pain in their right abdomen so that they can learn the pros and cons of removing the gallbladder.
Still, Kumta says that obesity is correlated with gallstone formation and that patients can make dietary changes, lose weight if they are obese, and opt for a low-fat diet.
If you pick the "change your diet, wait and see" approach, be mindful of the factors that predispose someone to gallstones: You can't control your age, your gender (women are more prone to gallstones), or your genes.
If you have gallstones, knowing what's available to remove or otherwise treat them can help you in making your treatment decisions. Discuss these treatment options with your doctor and find the one that's right for you.
Additional reporting by Calley Nelson.
What Is A Penile Yeast Infection?
Penile yeast infections can cause uncomfortable symptoms. You can treat them with over-the-counter and prescription medications, depending on severity. Certain steps like practicing proper hygiene can reduce the risk.
A yeast infection is often thought of as a female health problem, but it can affect anyone, including people with a penis.
A penile yeast infection can lead to a wide range of painful and uncomfortable symptoms if not treated. It can also lead to serious complications if the infection spreads to your bloodstream.
Over-the-counter (OTC) medications can often clear up a yeast infection. In some cases, you may need prescription medications. Some basic prevention steps can help you avoid this fairly common condition.
Some of the most common symptoms of a penile yeast infection include:
Redness, itchiness, and pain in the penis can be signs of other more serious conditions, like some sexually transmitted infections (STIs), so do not ignore symptoms once they appear.
A urologist or primary care doctor can diagnose the condition, often in a single appointment.
A yeast infection is usually caused by a fungus called candida. A small amount of candida is usually present in the body. All it takes is an overgrowth of candida to develop a yeast infection.
A moist environment is ideal for candida to spread, according to 2018 research.
Having sex with a person who has a vaginal yeast infection without using a condom can also cause a penile yeast infection. However, you can also develop an infection without sexual activity.
Aside from sex with a partner who has a yeast infection, several other factors can increase your risk of developing a penile yeast infection, such as:
Once you make an appointment, a doctor will ask you about your symptoms and likely examine your genitals. They may examine some of the white substance that forms on the penis under a microscope to confirm the type of fungus causing the symptoms.
If you cannot get in to see a primary care doctor or a urologist, consider a visit to an urgent care center or an emergency department. The earlier you receive a diagnosis and can begin treatment, the more likely it is you can avoid complications.
It's not recommended for you to diagnose yourself and start treatment on your own. If symptoms of a yeast infection are present, contact a doctor. If symptoms are allowed to persist, complications can be serious.
In most cases, topical antifungal ointments and creams are enough to clear up an infection. Some of the antifungal creams recommended for a yeast infection include:
Most of these are available as OTC medications, which means you will not need a prescription. More serious or long-term infections may require prescription-strength medication.
A doctor may recommend oral fluconazole (Diflucan) and hydrocortisone cream for serious infections, like those that have developed into a potentially serious condition called balanitis.
Most antifungal creams are well tolerated and unlikely to cause any serious side effects. Check the label, however, and ask a doctor and pharmacist what to look out for in case you have a bad reaction.
Recurrent yeast infectionsYeast infections sometimes return after they seem to have been cured. If this happens, your doctor will likely recommend a few weeks of daily treatments followed by a few months of weekly treatments.
In some cases, treatment for recurrent yeast infections can last up to 6 months.
If your infection does not respond well to an antifungal ointment and you are uncircumcised, a doctor may advise you to have an adult male circumcision, according to 2016 research. Though this procedure is usually done on infants, it can be done safely on people of any age.
Diabetes and yeast infectionsFactors like diabetes and a suppressed immune system may contribute to your yeast infection risk, according to 2019 research.
If you have diabetes, work with a healthcare professional to make sure your blood sugar levels are well-managed. If you have a suppressed immune system, a doctor can recommend ways to help keep your immune system as healthy as possible.
If left untreated, a penile yeast infection can lead to some serious complications.
BalanitisOne of the potential complications of a penile yeast infection is balanitis. Balanitis is an inflammation of the head of the penis (glans). Some people experience inflammation of both the glans and the foreskin, known as balanoposthitis.
Diabetes can increase your risk for balanitis.
Without effective treatment, balanitis can lead to scarring of the foreskin. It can also cause adhesions on the penis. It may prevent you from being able to pull your foreskin back, making proper hygiene impossible. A doctor will likely recommend circumcision in these cases.
Balanitis can be painful and make urinating more difficult. If untreated, it can cause swollen and painful glands as well as weakness and fatigue.
Invasive candidiasisA yeast infection may enter the bloodstream. This is known as candidemia or invasive candidiasis.
This is most common in people who wait to receive treatment until the infection has spread beyond the penis. It is also more common in those with weakened immune systems.
If you've been in a hospital and used a catheter to urinate, you may be more likely to face invasive candidiasis. This advanced form of yeast infection is very serious. Medical staff will closely monitor you for any signs of a catheter-associated urinary tract infection (CAUTI).
You may need oral antifungal medications for several weeks. In some cases, the drugs are administered intravenously.
If your infection is treated early and responds well to antifungal medication, it can clear up within 7–14 days.
If you are sexually active, your partner should also receive treatment for a yeast infection. This prevents them from contracting the infection or passing it back to you.
If you get repeated yeast infections and can rule out causes like hygiene and sexual contact, talk with a doctor about other possible causes. You may have an underlying health condition, such as diabetes.
You can help prevent a penile yeast infection by avoiding sexual contact with a partner who has a yeast infection.
You should also avoid having sex with anyone while you have an active yeast infection, as you could pass the infection back to your partner. This could cause the two of you to pass an infection back and forth.
To lower the risk of getting a yeast infection or passing one along, do the following:
A penile yeast infection may look like a scaly and red rash on the underside of the penis. Although not always the case, you may also experience inflammation around the head of the penis. In some cases, a yellowish or milky discharge is also present and accumulates under the foreskin, which makes it harder to pull it back.
Cracked foreskin, red spots, and white patches are also common in penile yeast infections. Itchiness, burning, or pain often accompany the rash.
Does a penile yeast infection go away on its own?Depending on the cause, a yeast infection may go away on its own or when the underlying cause is addressed. But untreated yeast infections in the penis may lead to complications in some cases, so consulting a healthcare professional is highly encouraged.
What do you do for a penile yeast infection?Treatment for yeast infections is available and effective. It may consist of OTC or prescription antifungal creams and oral medications for 1 to 2 weeks. Symptoms of penile yeast infections may be similar to those of other conditions, including some sexually transmitted infections, which require different treatment approaches. Only a medical professional can provide an accurate diagnosis.
Penile yeast infections are not as common as vaginal yeast infections, but they do occur. They may result from poor hygiene or sex with a partner who has a vaginal yeast infection without using an external condom.
Symptoms include small white patches and redness on the skin as well as itchiness or burning. If left untreated, it can also cause other conditions and complications.
Topical antifungal ointments and creams can typically treat the infection and reduce the risk of long-term complications.
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